18 patients with a displaced (>2mm) base of the 5th metatarsal fracture were randomized to be treated with either open reduction and internal fixation (ORIF) or nonoperative management with a short leg cast. The purpose of this study was to compare clinical measures of pain and function, time to union, and restoration of injured metatarsal length between groups. Follow-up was performed for an average of 8.5 weeks. Results demonstrated no significant differences in pain or functional scores, despite a significantly shorter time to union in the operative group.